文档介绍：Neurologic & Muscular Disorders
Zhou Shuizhen (周水珍)
Department of Neurology
Children’s Hospital of FuDan University
Part I: General Consideration
Anatomical and physiology features of the S
Neurological examination of children
Key facts about neurological disorders in children:
– Infections of S
– Neurocutaneous syndromes
– Cerebral palsy
– Progressive muscular dystrophy
– Seizure disorders (epilepsies & non-epilepsy seizures)
– Convulsions & Weakness (PBL)
Physiologic and anatomical features
of the S
1. Brain
- weight : at birth 6m 1y 2y 4-6y adult
370 700 900 1000 1300 1500 (g) - cerebra / pallium / cell number …
- myelinization: fetal period ~ 4yrs.
2. Spinal Cord
- weight: 2~6g (at birth)
- terminal : L3 (fetal); L1(4y)
- myelinization: 3y
Neurological examination of children
A child’s nervous system is continuous development
Methods of neurological must be adapted to
the child’s developmental stage
Neurological signs are altered by external factors
Examination reveals presence of abnormalities,
locations of lesions and clues of etiology
I. General observation
1. General observation: Hyperactivity, attention, emotional state
2. Consciousness: Level; Quality
3. Speech & language: Eye to eye contact ; Gestures
Articulation; Understanding; Expression
4. Facies and Head: Size, shape of head; Fontanelle, size &
tension; Bruit, transillumination of head
5. Neck: Movement, deformity, signs of meningeal irritation
6. Skin: Cafe au lait spots, telangiectasis, haemangiomas
II. Cranial nerves
1. Smell
2. Vision-field, acuity, abnormal eye movement
3. Pupil size, reactions
4. Fundi
5. Ocular movement, squint, nystangmus, ptosis, sun-set sign
6. Jaw movement, jaw jerk, facial sensation & corneal reflex
7. Ear examination, hearing, vestibular function
8. Paltal movement, gag reflex
9. Rotate head, elevate shoulders, extend neck
10. Tongue-protrusion, atrophy, fasciculation,
percussion-myotonia
III.